Using Mindfulness for Chronic Pain

Mindfulness can be an effective tool in chronic pain management. There are several benefits and ways of practicing mindfulness for chronic pain sufferers. There are a few pitfalls to avoid so you can get the benefits.

What is Mindfulness?

Mindfulness is about being present in the moment, accepting what is without judgment, and letting it be. A leader in mindfulness practice, John Kabat-Zinn, has described mindfulness as “awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.”

What is Chronic Pain?

Chronic pain persists beyond the average injury recovery time or three months. It can occur after an injury or without apparent cause. Living with chronic pain can have a significant impact on your whole life, including your relationships, quality of life, and mental and physical health. Your chronic pain may impact your independence, mobility and ability to work. Also, experiencing depression, anxiety, and increased stress is normal for chronic pain sufferers.

How Mindfulness Benefits Your Chronic Pain Experience?

Mindfulness has been shown through brain imaging to reduce activation in areas of the brain that manage pain messages. It can also reduce a person’s need for pain medications (Zeidan et al., 2015).

Mindfulness can help chronic pain sufferers focus their minds and body in the moment without judgment. It can move you away from negative or worrisome thoughts that can affect your mood and increase your pain.

How Mindfulness Affects the Brain

Mindfulness can improve four brain processes: sustained attention, monitoring faculty (detects wind wandering), attentional switching (ability to disengage from a distracting object without further involvement), and selective attention (ability to redirect focus to the chosen object).

Mindfulness activates the areas of the brain that:

• Help to process memories and information.
• Regulate the internal processes in the body, which essentially refers to all the body’s systems such as breathing, heart rate, blood flow and immune system, to mention a few.
• Focus on problem-solving.
• Help to focus attention.
• Regulating and controlling emotions
• Helps with adaptive, healthy behaviours.

People who regularly practice mindfulness or meditation have increased gray matter in the brain. It can help you control your emotions, control movement, help with sensory perception and memory, think things through, solve issues, and adapt to changes in your life.

How Mindfulness Affects Different Systems and Cycles with Chronic Pain

Mindfulness can reduce the stress involved in the pain and stress cycle. The stress can exacerbate pain, and pain is stressful to deal with, which exacerbates stress.

Mindfulness can trigger a more relaxed state by activating the parasympathetic nervous system, resulting in relaxing muscles, slowing blood pressure and heart rate, and slower breathing. How relaxed you can get through mindfulness can depend on other limiting factors such as trauma and inner pressure.

Mindfulness can help to desensitize your pain alarm system so you don’t experience pain flares as often.

How Mindfulness Affects the Mental Aspects of Chronic Pain

Mindfulness can reduce anxiety and other mental health challenges that can come with chronic pain. It can improve well-being, quality of life, and positivity.

Mindfulness can help with pain acceptance, which can lower the burden of negative thoughts and increase a sense of control. It can also improve your response to treatment.

Mindfulness can lower your hypervigilance (constant awareness of your pain) and fear avoidance, which feeds the pain cycle, worsens symptoms and reduces functioning.

You can use mindfulness to overcome pain catastrophizing. Mindfulness can balance the activity of the amygdala and prefrontal cortex to allow us to reduce fear and take control of it.

Mindfulness can help us be less hard on ourselves. Self-compassion mindfulness can reduce anxiety and pain. It can calm your inner critic. It can improve emotional and cognitive flexibility and reduce rumination and reactivity.

How Mindfulness Affects Quality of Life

Using mindfulness in bed can increase relaxation and promote sleep. It can improve quality of life and chronic pain long-term because people now have the tools to maintain and progress the changes.

How Mindfulness Affects Pain

Mindfulness can help you to ride the waves of pain, realizing the pain will increase and decrease. Each pain flare will come back down.

Mindfulness can have a moderate effect on pain intensity. However, it improves other vital aspects of life, such as depression, coping ability, quality of life, acceptance, and sleep quality.

Mindfulness can also enable people to tolerate higher levels of pain. When people with pain are practicing mindfulness and aware of the sensory aspects of pain, their experience of pain is less unpleasant. Mindfulness likely reduces the brain activation in brain networks related to memory, emotion and self-referential thought. It is likely due to a calming of our emotional response to pain and the acceptance of pain. Moreover, mindfulness trains your brain to experience pain with less distress.

Mindfulness Practice for Chronic Pain

Mindfulness is not a magic pill. It is a skill that takes practice. It is about re-training the brain not to be as reactive. In the studies comparing the effects of mindfulness and CBT, the results have been similar.

How to Do Mindfulness for Chronic Pain?

Basic Skills of Mindfulness

Mindfulness is about being fully in the present moment without judgment. There are three “What” skills (Observation, Describing, Participation) and three “How” skills (Nonjudgmental, One-mindedness, Effectiveness).

Observation

Observing is sensing or experiencing without describing or labelling the experience. It isn’t easy at first, but the benefit of this practice is that the mind becomes quiet. Eventually, you can observe things without a running commentary of a talkative mind.

Describing

Describing is simply putting words on what you observe. It is labelling the experience without judgment. For instance, take an experience such as washing the dishes and say to yourself statements about what you observe. “The water is gray. The soap feels slippery in my hands. The dish is hot.” Describing events and personal responses with words develops the ability to label environmental events and behaviours. The ability to describe what you feel and do when you are nervous, anxious, upset, impatient, fearful, excited, or tired helps you observe more clearly the connections between yourself and your environment. Observing and describing together can help you stay in the present moment and focus on doing what you can now to improve your situation.

Participation

Participating is entering wholly into an activity. It is throwing yourself into something completely. Let yourself get involved in the moment, letting go of ruminating and self-consciousness. Be fully present when engaging in an activity. By participating with awareness, we can be in the moment, allowing us to step back from our lives and thoughts and be aware that we are alive and okay right now. It is a great tool to use when you’re in distress.

Nonjudgmental

A judgment is putting an opinion or a qualifier on an observation. For example, sadness is a bad emotion. The judgement is “bad.” By developing the nonjudgmental perspective, you can separate your experiences from the judgments that can increase your suffering.

One-mindedness

The idea of one-mindedness is to do one thing at a time. The reasons for this are so that you can give your full attention to what you are doing, do your best job, and feel completely present and not fragmented when doing these important things. Mindfulness is about the quality of awareness we bring to our current task. It’s about not allowing yourself to be distracted by images, worries, thoughts, and past feelings.

Effectiveness

The goal of the therapy, in general, is to be effective. It’s about focusing on doing what works rather than what is “right” versus “wrong” or “fair” versus “unfair.” Being effective is often allowing yourself to let go of the need to be or feel ‘right.’ It overshadows our ability to make decisions that may correct a situation. Being determined to be right or feeling it’s a matter of principle can be a very self-defeating goal. In other words, letting go of a desire to be correct and doing what works using DBT skills is effective.

Individual Mindfulness Meditation

Meditation can involve sitting alone in a quiet, comfortable space and focusing on the present moment. You may focus on breathing, what is coming through your senses, or a body scan. If thoughts or emotions come up, it’s about letting them flow past you without attaching any significance to them.

Guided Mindfulness Meditation

Guided meditation involves listening to someone who helps you relax into a meditative state and guides you through the meditation.

Mindful Movement

Mindful movement is about combining movement and mindfulness.

Yoga and other calm, flowing body movements can be used in mindfulness practice, where you focus on your breath and how your body is moving in the moment.

Walking mindfulness focuses on what is coming through your senses, breath, and movement as you walk. Being in nature can be helpful and soothing to your nervous system.

Mindfulness-Based Stress Reduction

Mindfulness-Based Stress Reduction (MBSR) was developed by Dr Jon Kabat-Zinn and focuses on reducing stress and its negative impacts on the body. It is described in detail in his book “Full Catastrophe Living.” It involves meditation, mind and body exercises, and gentle exercise. Additionally, it was found to have multiple benefits for improving chronic pain, such as reduced pain intensity, reduced pain-related distress, better coping with symptoms, improved well-being, and enhanced health outcomes.

Daily Mindfulness

You can practice mindfulness informally by integrating mindfulness into your daily life. It’s about focusing on the here and now and appreciating the present moment. You can do this by focusing on what is coming through your senses while engaging with daily tasks like doing the dishes, eating, and taking a shower.

Pitfalls of Mindfulness for Chronic Pain

Pain Intensity

Your level of pain may impact your ability to engage in mindfulness. Mindfulness can be effective when your pain is mild to moderate. When your pain is severe, it can be challenging to engage in mindfulness. Suppose you have established mindfulness practice when your pain is lower in intensity. In that case, your practice may still be effective during pain flares and severe pain.

Inner Threat Level

Sometimes, you can limit the benefits of mindfulness. When you bring too much intensity to your mindfulness practice, your brain may interpret that as threatening, and you won’t get the same benefit.

Guided Mindfulness that Triggers Pain

You may experience pain if you listen to a guided mindfulness meditation that gets you to imagine doing things that would usually cause you pain if you were to do those same things in real life.

Lack of Accommodation for Pain Limitations

It’s important to respect your limitations when doing mindfulness. For example, if sitting causes pain, find another position when engaging in mindfulness.  

Outcome Focus

When you do mindfulness to reduce your pain and are watching for a pain reduction, you probably won’t get it. The act of waiting or expecting a certain outcome can be interpreted as a threat to your system and prevents you from relaxing into the practice and fully engaging in it.

Conclusion

Mindfulness can be an effective tool in chronic pain management. There are several benefits and ways of practicing mindfulness for chronic pain sufferers. As long as you avoid some pitfalls, you can achieve these benefits from practicing mindfulness.